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2. An open letter to The BMJ editors on qualitative research

Author

Greenhalgh, Trisha, Annandale, Ellen, Ashcroft, Richard, Barlow, James, Black, Nick, Bleakley, Alan, Boaden, Ruth, Braithwaite, Jeffrey, Britten, Nicky, Carnevale, Franco, Checkland, Kath, Cheek, Julianne, Clark, Alex, Cohn, Simon, Coulehan, Jack, Crabtree, Benjamin, Cummins, Steven, Davidoff, Frank, Davies, Huw, Dingwall, Robert, Dixon-Woods, Mary, Elwyn, Glyn, Engebretsen, Eivind, Ferlie, Ewan, Fulop, Naomi, Gabbay, John, Gagnon, Marie-Pierre, Galasinski, Dariusz, Garside, Ruth, Gilson, Lucy, Griffiths, Peter, Hawe, Penny, Helderman, Jan-Kees, Hodges, Brian, Hunter, David, Kearney, Margaret, Kitzinger, Celia, Kitzinger, Jenny, Kuper, Ayelet, Kushner, Saville, Le May, Andree, Legare, France, Lingard, Lorelei, Locock, Louise, Maben, Jill, Macdonald, Mary Ellen, Mair, Frances, Mannion, Russell, Marshall, Martin, May, Carl, Mays, Nicholas, McKee, Lorna, Miraldo, Marissa, Morgan, David, Morse, Janice, Nettleton, Sarah, Oliver, Sandy, Pearce, Warrren, Pluye, Pierre, Pope, Catherine, Robert, Glenn, Roberts, Celia, Rodella, Stefania, Rycroft-Malone, Jo, Sandelowski, Margarete, Shekelle, Paul, Stevenson, Fiona, Straus, Sharon, Swinglehurst, Deborah, Thorne, Sally, Tomson, Göran, Westert, Gerd, Wilkinson, Sue, Williams, Brian, Young, Terry, and Ziebland, Sue

Published
2016
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4. Scaling-up Complex Interventions : Adaptation is not a Threat to Fidelity

Author

Hawe, Penny

Abstract

Practitioners delivering evidence-based interventions get pulled in different directions. It is intuitive to adapt interventions to context, but usually against ‘standard’ recommendations to do so. The nexus of the problem lies with different understandings of “complex.” This seminar puts forward the argument that with complex-system thinking, program scale-up should be less about precise replication and more about (re)generation according to the principal mechanisms of action. This means that fidelity and adaptation may co-exist, rather than the conventional logic, where adaptation is routinely seen as a threat to fidelity. With the complex way of thinking, intervention and context are intertwined. This means adaptation is not an add on consideration – it is integral to design and hence integral to transfer to every context. Practice has long been recognised as messy. Yet there remains a dominant orthodoxy which makes program implementation and scale-up sound simpler than it is. New ways forward will require innovative forms of quality assurance and accountability. This seminar investigates these issues, drawing on the burgeoning literature in complex systems and current examples from research with population-level interventions. It shows how insights from applied implementation practice could be harvested and harnessed to improve the reach and effect of interventions.

Published
2020

5. Communicating the benefits of population health interventions: The health effects can be on par with those of medication

Author

Astell-Burt, Thomas E, Rowbotham, Samantha J, Hawe, Penny, Astell-Burt, Thomas E, Rowbotham, Samantha J, and Hawe, Penny

Abstract

How can we communicate to the public that population level health interventions are effective at improving health? Perhaps the most familiar "currency" of effect is that which can be brought about via medication. Comparisons of effect sizes may be effective ways of communicating the benefits of population health interventions if they are seen and understood in the same way that medications are. We developed a series of comparisons to communicate benefits of population health interventions in terms of similar gains to be obtained from statins, metformin and antihypertensive medications for prevention of cardiovascular events, type 2 diabetes, obesity and hypertension. A purposive search identified evidence of population health intervention-related benefits. This evidence ranged from meta-analyses of RCTs to that from observational cohort studies. Population health interventions included implementation of national smoke free legislation, enhanced neighbourhood walkability, increased opportunities for active travel and protection of urban green space. In some cases, the benefits of population health interventions were found to be equivalent to, or even outweighed those of the medications to which they were compared. For example, RCT-based evidence suggested that exercise taken with a view of a green space was associated with 12 mmHg and 6 mmHg reductions in systolic and diastolic blood pressure, respectively, which was at least on par with the reductions associated with antihypertensive medications. Future work will test the effectiveness of these comparisons for increasing the familiarity, credibility and acceptability of population health interventions and, in particular, examine the importance of communicating putative mechanisms and potential co-benefits.

Published
2018

6. Does citizen science have the capacity to transform population health science?

Author

Rowbotham, Samantha, McKinnon, Merryn, Leach, Joan, Lamberts, Roderick, Hawe, Penny, Rowbotham, Samantha, McKinnon, Merryn, Leach, Joan, Lamberts, Roderick, and Hawe, Penny

Abstract

Citizen science engages members of the public in research design, data collection, and analysis – in asking and answering questions about the world around them. The United States, European Union, and Australia have placed citizen science at the forefront of national science policy. Journals such as Science, Nature and Bioscience regularly feature projects conducted by citizens. Citizen science engages millions of people worldwide. However, to date, population health science has not relied heavily on citizen contributions. Although community-based participatory action research remains a strong foundational method to engage those affected by public health problems, there is additional potential to mainstream population health through wider, less intensive opportunities to be involved in our science. If we are to tackle the complex challenges that face population health then new avenues are needed to capture the energy and attention of citizens who may not feel affected by public health problems, i.e. to engage the ‘by-standers’ in population health science. Particular types of citizen science methods have the potential to do this. But simply increasing the breadth and volume of scientific evidence will not be enough. Complex, intractable, macro-level problems in population health require change in how our journals and funding bodies respond to data generated by the public. Of course, democratisation of science and the potential decentralisation of scientific authority will bring deep challenges. But potentially it brings a future where population health science is better known, understood and respected, with benefits for the types of public policies that derive from this science.

Published
2017

7. An open letter toThe BMJeditors on qualitative research

Author

Greenhalgh, Trisha, primary, Annandale, Ellen, additional, Ashcroft, Richard, additional, Barlow, James, additional, Black, Nick, additional, Bleakley, Alan, additional, Boaden, Ruth, additional, Braithwaite, Jeffrey, additional, Britten, Nicky, additional, Carnevale, Franco, additional, Checkland, Kath, additional, Cheek, Julianne, additional, Clark, Alex, additional, Cohn, Simon, additional, Coulehan, Jack, additional, Crabtree, Benjamin, additional, Cummins, Steven, additional, Davidoff, Frank, additional, Davies, Huw, additional, Dingwall, Robert, additional, Dixon-Woods, Mary, additional, Elwyn, Glyn, additional, Engebretsen, Eivind, additional, Ferlie, Ewan, additional, Fulop, Naomi, additional, Gabbay, John, additional, Gagnon, Marie-Pierre, additional, Galasinski, Dariusz, additional, Garside, Ruth, additional, Gilson, Lucy, additional, Griffiths, Peter, additional, Hawe, Penny, additional, Helderman, Jan-Kees, additional, Hodges, Brian, additional, Hunter, David, additional, Kearney, Margaret, additional, Kitzinger, Celia, additional, Kitzinger, Jenny, additional, Kuper, Ayelet, additional, Kushner, Saville, additional, May, Andree Le, additional, Legare, France, additional, Lingard, Lorelei, additional, Locock, Louise, additional, Maben, Jill, additional, Macdonald, Mary Ellen, additional, Mair, Frances, additional, Mannion, Russell, additional, Marshall, Martin, additional, May, Carl, additional, Mays, Nicholas, additional, McKee, Lorna, additional, Miraldo, Marissa, additional, Morgan, David, additional, Morse, Janice, additional, Nettleton, Sarah, additional, Oliver, Sandy, additional, Pearce, Warrren, additional, Pluye, Pierre, additional, Pope, Catherine, additional, Robert, Glenn, additional, Roberts, Celia, additional, Rodella, Stefania, additional, Rycroft-Malone, Jo, additional, Sandelowski, Margarete, additional, Shekelle, Paul, additional, Stevenson, Fiona, additional, Straus, Sharon, additional, Swinglehurst, Deborah, additional, Thorne, Sally, additional, Tomson, Göran, additional, Westert, Gerd, additional, Wilkinson, Sue, additional, Williams, Brian, additional, Young, Terry, additional, and Ziebland, Sue, additional

Published
2016
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11. Promoting physical activity in women: evaluation of a 2-year community-based intervention in Sydney, Australia.

Author

Li Ming Wen, Thomas, Margaret, Jones, Helen, Orr, Neil, Moreton, Renee, King, Lesley, Hawe, Penny, Bindon, Jeni, Humphries, Jenni, Schicht, Karin, Corne, Shauna, and Bauman, Adrian

Subjects
WOMEN'S health, HEALTH promotion, PHYSICAL fitness
Abstract

Women are less likely than men to reach recommended levels of physical activity and have unequal access to active leisure time. Studies in Australia have consistently found that women are only half as likely as men to be adequately active. A community-based multi-strategic health promotion intervention, 'Concord, A Great Place to be Active', was implemented from 1997 to 1999. It aimed to increase the physical activity levels of women aged 20-50 years living in the Concord Local Government Area (LGA), an inner- western region of Sydney. Australia. A key feature of this intervention was a partnership between Concord Council (the local government) and the Central Sydney Health Promotion Unit (CSHPU). The project was evaluated using qualitative and quantitative methods. Key informant interviews and focus groups were conducted to inform the development of the intervention and to assess the impact of the project on Concord Council. Pre- and post-intervention telephone surveys of the target group were also conducted. Following the intervention, there was a statistically significant (6.4%) reduction in the proportion of sedentary women. Further, there were a number of positive enhancements in the Council's capacity to promote physical activity in the community. These findings demonstrate that a community-based intervention targeting a specific population can achieve positive changes in physical activity and that a local government has the capacity to be involved in and sustain physical activity interventions. [ABSTRACT FROM AUTHOR]

Published
2002
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12. Intake II, a Study of 400 Cases.

Author

Barker, Judy, Dent, John, Hawe, Penny, Armour, Susan, Hagen, Wendy, Tolliday, Frances, Salgado, Gilda, and Dawson, Robin

Abstract

An evaluation of 400 completed cases over a 17 week period was undertaken by an Intake team of social workers in Westmead Centre, a large teaching hospital in the western suburbs of Sydney. It discusses a profile of the clients referred, the nature of the problems identified and the services provided. In the analysis of the 400 cases studied, it considers the Intake team's services, the skills required by Intake workers to meet the psychosocial problems identified, and the implications for the organisation of a social work service delivery. Recommendations for the institution of such a system of social work service delivery are part of the ensuing analysis. [ABSTRACT FROM PUBLISHER]

Published
1985
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13. TALK TO US.

Author

Hawe, Penny and Maclennan, Bruce

Published
2018

14. An open letter to The BMJeditors on qualitative research

Author

Greenhalgh, Trisha, Annandale, Ellen, Ashcroft, Richard, Barlow, James, Black, Nick, Bleakley, Alan, Boaden, Ruth, Braithwaite, Jeffrey, Britten, Nicky, Carnevale, Franco, Checkland, Kath, Cheek, Julianne, Clark, Alex, Cohn, Simon, Coulehan, Jack, Crabtree, Benjamin, Cummins, Steven, Davidoff, Frank, Davies, Huw, Dingwall, Robert, Dixon-Woods, Mary, Elwyn, Glyn, Engebretsen, Eivind, Ferlie, Ewan, Fulop, Naomi, Gabbay, John, Gagnon, Marie-Pierre, Galasinski, Dariusz, Garside, Ruth, Gilson, Lucy, Griffiths, Peter, Hawe, Penny, Helderman, Jan-Kees, Hodges, Brian, Hunter, David, Kearney, Margaret, Kitzinger, Celia, Kitzinger, Jenny, Kuper, Ayelet, Kushner, Saville, May, Andree Le, Legare, France, Lingard, Lorelei, Locock, Louise, Maben, Jill, Macdonald, Mary Ellen, Mair, Frances, Mannion, Russell, Marshall, Martin, May, Carl, Mays, Nicholas, McKee, Lorna, Miraldo, Marissa, Morgan, David, Morse, Janice, Nettleton, Sarah, Oliver, Sandy, Pearce, Warrren, Pluye, Pierre, Pope, Catherine, Robert, Glenn, Roberts, Celia, Rodella, Stefania, Rycroft-Malone, Jo, Sandelowski, Margarete, Shekelle, Paul, Stevenson, Fiona, Straus, Sharon, Swinglehurst, Deborah, Thorne, Sally, Tomson, Göran, Westert, Gerd, Wilkinson, Sue, Williams, Brian, Young, Terry, and Ziebland, Sue

Published
2016
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